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      Comparison of anterior chamber flare among different glaucoma surgeries

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          Abstract

          Purpose

          To compare postsurgical anterior chamber flare (ACF) among conventional (trabeculectomy, LEC) and novel (EX-PRESS Shunt, EXP) filtration surgeries and microhook ab interno trabeculotomy (μLOT), a novel minimally invasive glaucoma surgery (MIGS).

          Subjects and methods

          This retrospective study included 125 primary open angle glaucoma eyes (89 consecutive subjects) treated with μLOT (n=38), LEC (n=12), or EXP (n=75). The intraocular pressure (IOP), numbers of antiglaucoma medication, and ACF at preoperatively and 2 weeks; 1, 3, and 6 months postoperatively were compared among the surgical groups using a mixed-effects regression model.

          Results

          The postoperative IOP ( p<0.0001) and medication use were significantly ( p<0.0001) lower in the LEC and EXP groups than with μLOT for up to 6 months postoperatively. The ACF differed significantly ( p=0.0004) among groups; the ACF was significantly higher ( p=0.0097, post-hoc Student’s t-test) with μLOT (33.6±52.8 pc/msec) than the EXP (15.7±19.9 pc/msec) at 2 weeks and was significantly ( p=0.0111, post-hoc t-test) lower with μLOT (7.9±2.0 pc/msec) than LEC (12.0±6.1 pc/msec) at 6 months.

          Conclusion

          Considering our observation, although its clinical significance is unclear, not all MIGS are minimally invasive regarding early postsurgical inflammation.

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          Short-term results of microhook ab interno trabeculotomy, a novel minimally invasive glaucoma surgery in Japanese eyes: initial case series.

          Masaki Tanito, Ichiya Sano, Yoshifumi Ikeda … (2017)
          To report the first early postoperative results and safety profile after microhook ab interno trabeculotomy (μLOT).
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            Canaloplasty: A Minimally Invasive and Maximally Effective Glaucoma Treatment

            Mahmoud Khaimi (2015)
            Canaloplasty is a highly effective, minimally invasive, surgical technique indicated for the treatment of open-angle glaucoma that works by restoring the function of the eye's natural outflow system. The procedure's excellent safety profile and long-term efficacy make it a viable option for the majority of glaucoma patient types. It can be used in conjunction with existing drug based glaucoma treatments, after laser or other types of incisional surgery, and does not preclude or affect the outcome of future surgery. Numerous scientific studies have shown Canaloplasty to be safe and effective in lowering IOP whilst reducing medication dependence. A recent refinement of Canaloplasty, known as ab-interno Canaloplasty (ABiC), maintains the IOP-lowering and safety benefits of traditional (ab-externo) Canaloplasty using a more efficient, simplified surgical approach. This paper presents a review of Canaloplasty indications, clinical data, and complications, as well as comparisons with traditional incisional glaucoma techniques. It also addresses the early clinical evidence for ABiC.
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              Comparison of surgically induced astigmatism following different glaucoma operations

              Masaki Tanito, Yukari Matsuzaki, Yoshifumi Ikeda … (2017)
              Aim To compare surgically induced astigmatism (SIA) among glaucomatous eyes treated with trabeculectomy (LEC), EX-PRESS® shunt (EXP), ab externo trabeculotomy (exLOT), or microhook ab interno trabeculotomy (μLOT). Subjects and methods Eighty right eyes of 80 subjects who underwent LEC (n=20), EXP (n=20), exLOT (n=20), or μLOT (n=20) were included. The dataset including the best-corrected visual acuity (BCVA), intraocular pressure (IOP), and keratometry recordings preoperatively and 3 months postoperatively was collected by chart review. The means of the vector magnitude, vector meridian, and arithmetic magnitude of the preoperative and postoperative astigmatism and SIA were calculated. The correlations among the SIA magnitude, postoperative BCVA, and IOP were assessed. Results The mean astigmatic arithmetic magnitudes did not differ significantly (P=0.0732) preoperatively among the four groups, but the magnitude was significantly (P=0.0002) greater in the LEC group than the other groups postoperatively. The mean SIA vectors were calculated to be 1.01 D at 56°, 0.62 D at 74°, 0.23 D at 112°, and 0.12 D at 97° for the LEC, EXP, exLOT, and μLOT groups, respectively. The mean SIA arithmetic magnitudes were significantly (P<0.0001) greater in the LEC group than the other groups. Three months postoperatively, the SIA magnitude was correlated positively with the logarithm of the minimum angle of resolution (logMAR) BCVA (r=0.3538) and negatively with the IOP (r=−0.3265); the logMAR BCVA was correlated negatively with the IOP (r=−0.3105). Conclusion EXP, exLOT, and μLOT induce less corneal astigmatism than LEC in the early postoperative period.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): OPTH
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 22 August 2019
                Publication date Collection: 2019
                Volume: 13
                Pages: 1609-1612
                Affiliations
                [1 ]Department of Ophthalmology, Shimane University Faculty of Medicine , Izumo, Japan
                [2 ]Division of Ophthalmology, Matsue Red Cross Hospital , Matsue, Japan
                Author notes
                Correspondence: Masaki TanitoDepartment of Ophthalmology, Shimane University Faculty of Medicine , 89-1 Enya-cho, Izumo, Shimane693-8501, JapanTel +81 85 320 2284Fax +81 85 320 2278Email tanito-oph@umin.ac.jp
                Article
                Publisher ID: 219715
                DOI: 10.2147/OPTH.S219715
                PMC ID: 6709819
                SO-VID: 54a79078-a160-4ba1-8c0e-603260ecad13
                Copyright © © 2019 Tanito et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 17 June 2019
                Date accepted : 13 August 2019
                Page count
                Tables: 1, References: 11, Pages: 4
                Categories
                Subject: Rapid Communication

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: anterior chamber flare,trabeculectomy,ex-press shunt,microhook ab interno trabeculotomy,minimally invasive glaucoma surgery,migs
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: anterior chamber flare, trabeculectomy, ex-press shunt, microhook ab interno trabeculotomy, minimally invasive glaucoma surgery, migs

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